NACCHO Aboriginal #MentalHealth and #SuicidePrevention @cbpatsisp : Health Minister @GregHuntMP welcomes the #YouCanTalk campaign, encouraging our mob struggling with their mental health to reach out and find support

“ The Federal Government welcomes the #YouCanTalk campaign, which encourages Australians struggling with their mental health to reach out and find support.

The awareness campaign is a collaboration between several organisations, including Beyond Blue, Everymind, headspace, Lifeline, ReachOut, RU OK?, SANE Australia, the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, Roses in the Ocean and the Black Dog Institute.

The campaign will take place over the December-January holiday period, in recognition of how difficult this time of year can be for many Australians.

Our Government commends the collaboration of these organisations to raise awareness about the importance of starting a conversation, particularly over the Christmas-New Year period.” 

Health Minister Greg Hunt Press Release continued Part 1 below 

Read over 160 Aboriginal Health and Suicide Prevention articles published by NACCHO over past 7 years 

” Suicide has emerged in the past half century as a major cause of premature mortality and is a contributor to the overall health and life expectancy gap for Aboriginal and Torres Strait Islander peoples.

In 2018 it was the fifth leading cause of death among Aboriginal and Torres Strait Islander peoples, and the age-standardised suicide rate was more than twice as high as the non-Aboriginal and Torres Strait Islander people’s rate.”

What we know about suicide for Aboriginal and Torres Strait Islander people : or see Part 3 Below

Sadly, more than 3,000 Australians choose to end their lives each year – about eight people a day.

Every life lost to suicide is a tragedy, creating a ripple effect that flows through families, friendship groups, schools, workplaces and communities.

That’s why the Federal Government has committed to Towards Zero – working towards reducing the suicide rate to zero.

Towards Zero is a total commitment to the value of each and every life, and recognises the importance of all lives, in all ages, and all groups.

This commitment is backed by our investment of $5.2 billion in mental health and suicide prevention services this financial year, including $63.3 million on suicide prevention activities.

It’s so important for Australians who are struggling to reach out and seek support.

The #YouCanTalk campaign also aims to connect people with tools that can support them through their website

www.lifeinmindaustralia.com.au/youcantalk.

#YouCanTalk exists to encourage all Australians to have a conversation with a friend, family member or work colleague they’re concerned about.

While it can be difficult to talk about suicide, research shows you can have a positive influence on someone who may be considering suicide by initiating a conversation with them and supporting them to seek help.

The main message is you don’t need to be a clinician, a GP, or a nurse to check-in with someone you are worried about.

It is OK to let someone know you have noticed they are struggling and ask them if they are experiencing thoughts of suicide.

It is normal to feel worried or nervous about having a conversation with a friend, family member or work colleague who might be experiencing suicidal thoughts, but there are resources available to help you.

Life in Mind is a national digital gateway providing organisations and communities access to suicide prevention information, programs, services, resources and research.

Part 3

Suicide has emerged in the past half century as a major cause of premature mortality and is a contributor to the overall health and life expectancy gap for Aboriginal and Torres Strait Islanders

In 2018 it was the fifth leading cause of death among Aboriginal and Torres Strait Islander peoples, and the age-standardised suicide rate was more than twice as high as the non-Aboriginal and Torres Strait Islander people’s rate.

The standardised death rate for Aboriginal and Torres Strait Islander peoples (24.1 per 100, 000) was higher than the non-Indigenous rate (12.4 per 100, 000)2.

On average, over 100 Aboriginal and Torres Strait Islander persons end their lives through suicide each year, accounting for 1 in 20 Aboriginal and Torres Strait Islander deaths.

STATISTIC

Further suicide data can be found at the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention, and from the ATSISPEP report.

Three main issues can be identified:

  1. There is variable quality of Aboriginal and Torres Strait Islander identification at the state and national levels, resulting in an expected under-reporting of Aboriginal and Torres Strait Islander suicides.
  2. Lack of reporting on suicide due to questions regarding intent, especially in the case of childhood suicides. Similarly, it can be demonstrated that there may be a reluctance to classify adult deaths as suicides for a variety of reasons also.
  3. Delays in reporting data, whereby incidences of Aboriginal and Torres Strait Islander suicide might not be known for months and often years after the fact.

NACCHO #VoteACCHO Aboriginal Health and #SuicidePrevention debate @TracyWesterman Suicide risk factors are being incorrectly stated as suicide causes : and Comments from Harley Thompson @TheAHCWA Youth Co-ordinator

” First, we need to recognise the significant societal contributors to escalating rates of child suicides.

And we need to start with changing the narrative on indigenous suicides.

The core driver is that indigenous suicide is badly understood and myths about so-called causes of suicide are portrayed as if they exist as a direct linear relationship.

Suicide risk factors are being incorrectly stated as suicide causes and this is critical to this whole issue. Alcohol, poverty, abuse, colonialisation — these are not causes. They are risk factors, not causes. It is vital we understand this distinction to ensure adequate prevention efforts.

So, what separates Person A, who has been abused and becomes suicidal, from Person B, who has been abused and does not?

While this is an essential question, we do not have clear evidence of these critical causal pathways ” 

Adjunct professor Tracy Westerman is a clinical psychologist and proud Njamal woman from the Pilbara region of Western Australia. She was named Western Australia’s Australian of the Year last year for working to reduce the burden of mental ill health and suicide in Aboriginal communities. See full article from The Australian below Part 1

 ” Labor’s response to rising rates of indigenous youth suicide is a vote of confidence in Aboriginal health organisations such as the one Ms Thompson works for. A Shorten Labor government would make an “urgent investment” of $29.6 million in those Aboriginal community-controlled health organisations that already treat 350,000 indigenous people a year.

The money would be used to create regionally based multi­disciplinary teams of paediatricians, child psychologists, social workers, mental health nurses and ­Aboriginal health practitioners tasked with suicide prevention in vulnerable communities. “

What Ms Harley Thompson has learned in her role as a youth ­program co-ordinator at the Aboriginal Health Council of Western Australia has been seized upon by politicians scrambling to respond to Australia’s indigenous youth suicide crisis. See Full Story part 2 below 

Read all NACCHO 130+ Aboriginal Health and Suicide Articles Here 

#VoteACCHO Recommendation 4 of 10.

Address Aboriginal and Torres Strait Islander youth suicide rates

  • Provide $50 million over four years to ACCHOs to address the national crisis in Aboriginal and Torres Strait Islander youth suicide in vulnerable communities
  • Fund new Aboriginal support staff to provide immediate assistance to children and young people at risk of self-harm and improved case management
  • Fund regionally based multi-disciplinary teams, comprising paediatricians, child psychologists, social workers, mental health nurses and Aboriginal health practitioners who are culturally safe and respectful, to ensure ready access to professional assistance; and
  • Provide accredited training to ACCHOs to upskill in areas of mental health, childhood development, youth services, environment health, health and wellbeing screening and service delivery.

See all 10 #VoteACCHO recommendations HERE

Part 1

Indigenous Affairs Minister Nigel Scullion has allocated $134 million for indigenous suicide prevention. This crudely translates to $248,000 per death based on the suicide mortality rate — without adding state funding into the mix.

From the Australian April 20

Despite this, and as a country facing a growing tragedy of generational indigenous child suicides, we still have no nationally accepted evidence-based programs across the spectrum of early intervention and prevention activities.

Staggeringly, funded programs are not required to demonstrate evidence of impact, nor are they required to demonstrate a measurable reduction in suicide and mental health risk factors.

So, given this, can governments truly claim they are funding suicide prevention? You cannot claim prevention if you aren’t measuring risk. It’s that simple.

In an area as complex as indigenous suicide, it is crucial that funding decisions unsupported by clinical and cultural expertise are challenged and redirected in the best way possible: towards the evidence. Report after report has pointed to the need for “evidence-based approaches”, but has anyone questioned why this continues to remain elusive?

Perhaps we need to start with what constitutes evidence.

It doesn’t mean attendance. This is not evidence of impact. It means measurable, outcome-based evidence — a reduction in suicide risk factors attributable to the intervention provided.

Without measurability there is no accountability. Without measurability we are failing to gather crucial evidence of what works to better inform current and future practitioners struggling to halt the intergenerational transmission of suicide risk.

Clinicians terrified

Up to 30 per cent of clinicians will experience the suicide death of a client in our clinical lifetime. It is complex, it is scary, and very few of us understand what it is like to feel as though you are holding someone’s life in your hands.

I can tell you that, despite extensive training, suicide prevention challenges you at every level.

It challenges your core values about the right of people to choose death over life; it stretches you therapeutically despite your training in best practice; and it terrifies you that you have missed something long after you have left your at-risk client.

The nature of suicide risk is that it changes. Being able to predict and monitor it takes years of clinical expertise and well-honed clinical insight and judgment.

Throw culture into the mix and this becomes a rare set of skills held by few in this country. Indeed, back-to-back coronial inquiries, a 2016 parliamentary inquiry and 2018 Senate inquiry all concluded that not only are ser­vices lacking in remote and rural areas of Australia but culturally appropriate services were often non-existent.

Prevention focus

First, we need to recognise the significant societal contributors to escalating rates of child suicides.

And we need to start with changing the narrative on indigenous suicides.

The core driver is that indigenous suicide is badly understood and myths about so-called causes of suicide are portrayed as if they exist as a direct linear relationship.

Suicide risk factors are being incorrectly stated as suicide causes and this is critical to this whole issue. Alcohol, poverty, abuse, colonialisation — these are not causes. They are risk factors, not causes. It is vital we understand this distinction to ensure adequate prevention efforts.

So, what separates Person A, who has been abused and becomes suicidal, from Person B, who has been abused and does not? While this is an essential question, we do not have clear evidence of these critical causal pathways.

Once we establish a causal pathway, we can then focus on determining treatments of best practice to ensure that clinicians are focused in the best possible way to eliminate the established cause.

This can be done only through rigorous assessment of individual risk factors. Some of these risk factors will be static and historical, meaning they cannot be changed: you cannot change someone’s date or place of birth, for example.

Other risk factors will be dynamic and changeable: we can work on changing anxiety and responses to trauma.

Once we have a comprehensive picture of an individual’s risk factors, treatment is then determined as being effective based on a reduction in the symptoms attributable to the clinical intervention. Presenting poverty and colonialisation as causes offers little to clinicians, who need to focus therapeutic interventions on what is alterative and treatable.

It distracts us from the true causes of indigenous suicide that enable a genuine opportunity for prevention. Our people are not killing themselves because they are poor. They are killing themselves because of racism, trauma, most likely co-morbid with depression and alcohol and drug use, isolation and a lack of access to culturally competent clinicians and evidence-based programs.

A further danger in confusing causes with risk factors is that it also informs government approaches to this issue.

So, taking this example of alcohol, the government decided to solve suicides through establishing dry communities and restricting alcohol. There has not been a decrease in suicide in alcohol-restricted communities; in fact, the opposite is true. Suicide is so multidimensional and multifaceted that, unless you can undertake rigorous assessment, there is going to be an endless cycle of risk that is “predicted” only once a child dies by suicide.

The most distressing outcome of failing to understand suicide causes is it further stigmatises bereaved Aboriginal parents, inferring that most, if not all, are perpetrators or alcoholics.

Perpetuating such stereotypes contributes to a general lack of empathy for Aboriginal people bereaved by suicide. It is a “they did it to themselves” mentality that is not only inaccurate but also unhelpful and unkind.

When non-indigenous children die by suicide, we rightly look for deficits in society or systems and how we need to “do better” as a society.

When indigenous children die by suicide, we look for deficits in their families, in their culture. Why don’t we have a more empathetic view of indigenous child suicides and for indigenous families bereaved by suicide?

Finding answers

Unfortunately the gaps are obvious and have been for decades.

First, universities need to set minimum standards of cultural competence as prerequisites in the degrees undertaken by those in the “helping professions”.

Most would be lucky to have an hour of cultural training in their degrees and then are sent out to remote indigenous communities where cultural barriers are so significant they render the most gifted clinicians into paralysis.

I have developed a normed Aboriginal Mental Health Cultural Competency Profile, which has demonstrated the capacity to measure, support and improve cultural competency development. This is objective and measurable, and provides a useful method for educational institutions to set minimum standards.

Second, we need to assess and screen for early risk. My PhD resulted in the development of the Westerman Aboriginal Symptom Checklist, a culturally validated psychometric test to screen youth at risk.

Despite this, we do not have a widely accepted methodology to assess for suicide risk in indigenous people.

While the youth version (WASCY) and adult version (WASCA) have existed for two decades, and more than 25,000 clinicians have chosen to be accredited in it, access into high-risk areas is limited by the lack of wide-scale government rollout of the tool.

Third, we need to understand the causes of indigenous suicide. The priority needs to be to analyse the suicide death data to firmly establish causal pathways to suicide. If the suicide data were analysed in a way that determined “causal” pathways it would quite simply change the paradigm of this area.

The big-picture thinking is to use continuous suicide data (suicide risk factors that move and change) gathered by the WASCY and WASCA to determine causal pathways and co-variates (that is, impulsivity, depression and suicide risk) and determine whether a reduction in these factors reduces the overall suicide death rate.

This is complex but these two data sets will enable us to determine what risk factors are reducing the suicide death rate in more of an immediate, measurable and responsive way.

Access to this data is likely to take many more months to pass through several ethics committees, but we will self-fund this analysis to fast-track this vital information and to speed up crucial gaps in our knowledge in this area.

Fourth, we need to determine whether indigenous suicide is different. The WASCY has determined a different set of risk factors for indigenous suicide, finding among other things that up to 60 per cent of suicide risk is accounted for by impulsivity.

Those with impulse-control issues are likelier to have limited coping mechanisms that enable self-soothing specific to interpersonal conflict. This pattern often occurs with those who have trauma and attachment-related issues — the origins of which for Aboriginal families often lie in the forcible removal from primary attachment figures.

With the increasing evidence of the impacts of race-based trauma there is a need to address societal contributors to indigenous suicides. Thema Bryant-Davis and Carlota Ocampo, among others, have noted similar courses of mental illness between victims of violent crime and victims of racism.

In Australia, Yin Paradies has found that racism explains 30 per cent of depression and reduces Aboriginal life expectancy more than smoking.

Just as trauma frequently becomes a central organising principle in the psychological structure of the individual, trauma has become a central organising principle in the psychological structure of whole communities. This is known as “repetition compulsion”, meaning individuals who have had a previous traumatic event are at increased risk for future trauma experiences.

Suicide “clusters” are an obvious and common consequence of trauma repetition compulsion.

From a suicide prevention perspective, racism manifests as a sense of hopelessness and helplessness, which has consistently been implicated in suicide risk. When the origin of this lies in rac­ial identity it seems inherently “untreatable” as a core risk factor and unchallengeable as a core driver when a suicidal individual develops thought processes based on a belief they don’t matter.

When those within the “system” and broader community show no visible sign of caring, this cognition then becomes increasingly ingrained through daily reinforcement.

The best I can do as a clinician is to assist my clients to develop healthy and robust cultural identity and develop the skills and resilience to manage racist events.

The WASCY provides a cultural resilience assessment that enables clinicians to “treat” factors that have been demonstrated to moderate or buffer suicide risk. This is crucial to prevention.

We are also about to publish on the impacts of a whole-of-community suicide intervention response to indigenous deaths.

This is the first evidence-based program to demonstrate a measurable reduction in suicide risk factors. It is crucial that these programs are widely available in high-risk communities.

Epigenetics tells us that racism impacts on Aboriginal people in the same way as a traumatic event. The fact most of our suicides are so impulsive makes absolute sense from a trauma perspective.

Finally, we turn to our political leadership. We look for guidance in what resonates in the conscience of our nation.

I wrote recently about the silence of our political leaders during the Fogliani coronial inquiry into the 13 deaths of indigenous children in the Kimberley.

Not a single question in the lower house of the West Australian parliament has been asked about the coroner’s report, nor what was going to be done about it.

The ABC reported only nine of the 95 members of parliament have brought up the inquest in any way, in either chamber, this year.

Studies support that a “hierarchy of newsworthiness” exists in which “cultural proximity” to the audience plays a crucial role in the extent of empathy generated for victims. The more the audience relates to victims, the greater the newsworthiness.

If the broader community can’t connect in a “this could happen to me or my family” manner, then there is less community outcry, and significantly less pressure on politicians to respond because, ­ultimately, they are very aware there will be little to no backlash about it.

When those who are mandated to care fail to respond your trauma becomes magnified.

The silence of our political leaders has served to magnify the trauma of these families and in effect has become systemically perpetuated by them.

Part 2

Hayley Thompson has been listening as Indigenous teenagers tell her what makes them happy as well as what troubles them, and she says the answers might surprise adults who believe social media makes young people miserable and even suicidal.

From The Australian April 20

“The young people don’t talk about social media as a problem,” Ms Thompson said. “The good thing about listening to the young people is you hear what they think is important, and that can be quite different to what older generations think is important.”

What Ms Thompson has learned in her role as a youth ­program co-ordinator at the Aboriginal Health Council of Western Australia has been seized upon by politicians scrambling to respond to Australia’s indigenous youth suicide crisis.

Indigenous Australians die by suicide at twice the rate of other Australians and this rate is even higher for youth. So far this year, 12 indigenous boys aged 12 to 18 have taken their own lives.

The tragedies have prompted questions about what works and what should happen next. In Inquirer today, clinical psychologist Tracy Westerman writes: “Suicide risk factors are being incorrectly stated as suicide causes and this is critical to this whole issue.”

Labor’s response to rising rates of indigenous youth suicide is a vote of confidence in Aboriginal health organisations such as the one Ms Thompson works for. A Shorten Labor government would make an “urgent investment” of $29.6 million in those Aboriginal community-controlled health organisations that already treat 350,000 indigenous people a year.

The money would be used to create regionally based multi­disciplinary teams of paediatricians, child psychologists, social workers, mental health nurses and ­Aboriginal health practitioners tasked with suicide prevention in vulnerable communities.

The Coalition’s mental health and suicide prevention plan includes $34.1m to “support indigenous leadership that delivers culturally appropriate, trauma-informed care” as well as “services that recognise the value of community, cultural artistic traditions and protective social factors”.

Indigenous Health Minister Ken Wyatt earlier gave just over $1m to the youth strategy Ms Thompson is part of. She says young indigenous people in cities and remote areas all tell her they want to feel closer to their culture.

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : @ozprodcom issues paper on #MentalHealth in Australia is now available. It asks a range of questions which they seek information and feedback on. Submissions or comments are due by Friday 5 April.

 ” Many Australians experience difficulties with their mental health. Mental illness is the single largest contributor to years lived in ill-health and is the third largest contributor (after cancer and cardiovascular conditions) to a reduction in the total years of healthy life for Australians (AIHW 2016).

Almost half of all Australian adults have met the diagnostic criteria for an anxiety, mood or substance use disorder at some point in their lives, and around 20% will meet the criteria in a given year (ABS 2008). This is similar to the average experience of developed countries (OECD 2012, 2014).”

Download the PC issues paper HERE mental-health-issues

See Productivity Commission Website for More info 

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. 

It is compounded by people’s lack of access to meaningful and ongoing education and employment. Drug and alcohol related conditions are also commonly identified in persons with poor mental health.

NACCHO Chairperson, Matthew Cooke 2015 Read in full Here 

Read over 200 Aboriginal Mental Health Suicide Prevention articles published by NACCHO over the past 7 years 

Despite a plethora of past reviews and inquiries into mental health in Australia, and positive reforms in services and their delivery, many people are still not getting the support they need to maintain good mental health or recover from episodes of mental ill‑health. Mental health in Australia is characterised by:

  • more than 3 100 deaths from suicide in 2017, an average of almost 9 deaths per day, and a suicide rate for Indigenous Australians that is much higher than for other Australians (ABS 2018)
  • for those living with a mental illness, lower average life expectancy than the general population with significant comorbidity issues — most early deaths of psychiatric patients are due to physical health conditions
  • gaps in services and supports for particular demographic groups, such as youth, elderly people in aged care facilities, Indigenous Australians, individuals from culturally diverse backgrounds, and carers of people with a mental illness
  • a lack of continuity in care across services and for those with episodic conditions who may need services and supports on an irregular or non-continuous basis
  • a variety of programs and supports that have been successfully trialled or undertaken for small populations but have been discontinued or proved difficult to scale up for broader benefits
  • significant stigma and discrimination around mental ill-health, particularly compared with physical illness.

The Productivity Commission has been asked to undertake an inquiry into the role of mental health in supporting social and economic participation, and enhancing productivity and economic growth (these terms are defined, for the purpose of this inquiry, in box 1).

By examining mental health from a participation and contribution perspective, this inquiry will essentially be asking how people can be enabled to reach their potential in life, have purpose and meaning, and contribute to the lives of others. That is good for individuals and for the whole community.

Background

In 2014-15, four million Australians reported having experienced a common mental disorder.

Mental health is a key driver of economic participation and productivity in Australia, and hence has the potential to impact incomes and living standards and social engagement and connectedness. Improved population mental health could also help to reduce costs to the economy over the long term.

Australian governments devote significant resources to promoting the best possible mental health and wellbeing outcomes. This includes the delivery of acute, recovery and rehabilitation health services, trauma informed care, preventative and early intervention programs, funding non-government organisations and privately delivered services, and providing income support, education, employment, housing and justice. It is important that policy settings are sustainable, efficient and effective in achieving their goals.

Employers, not-for-profit organisations and carers also play key roles in the mental health of Australians. Many businesses are developing initiatives to support and maintain positive mental health outcomes for their employees as well as helping employees with mental illhealth continue to participate in, or return to, work.

Scope of the inquiry

The Commission should consider the role of mental health in supporting economic participation, enhancing productivity and economic growth. It should make recommendations, as necessary, to improve population mental health, so as to realise economic and social participation and productivity benefits over the long term.

Without limiting related matters on which the Commission may report, the Commission should:

  • examine the effect of supporting mental health on economic and social participation, productivity and the Australian economy;
  • examine how sectors beyond health, including education, employment, social services, housing and justice, can contribute to improving mental health and economic participation and productivity;
  • examine the effectiveness of current programs and Initiatives across all jurisdictions to improve mental health, suicide prevention and participation, including by governments, employers and professional groups;
  • assess whether the current investment in mental health is delivering value for money and the best outcomes for individuals, their families, society and the economy;
  • draw on domestic and international policies and experience, where appropriate; and
  • develop a framework to measure and report the outcomes of mental health policies and investment on participation, productivity and economic growth over the long term.

The Commission should have regard to recent and current reviews, including the 2014 Review of National Mental Health Programmes and Services undertaken by the National Mental Health Commission and the Commission’s reviews into disability services and the National Disability Insurance Scheme.

The Issues Paper
The Commission has released this issues paper to assist individuals and organisations to participate in the inquiry. It contains and outlines:

  • the scope of the inquiry
  • matters about which we are seeking comment and information
  • how to share your views on the terms of reference and the matters raised.

Participants should not feel that they are restricted to comment only on matters raised in the issues paper. We want to receive information and comment on any issues that participants consider relevant to the inquiry’s terms of reference.

Key inquiry dates

Receipt of terms of reference 23 November 2018
Initial consultations November 2018 to April 2019
Initial submissions due 5 April 2019
Release of draft report Timing to be advised
Post draft report public hearings Timing to be advised
Submissions on the draft report due Timing to be advised
Consultations on the draft report November 2019 to February 2020
Final report to Government 23 May 2020

Submissions and brief comments can be lodged

Online (preferred): https://www.pc.gov.au/inquiries/current/mental-health/submissions
By post: Mental Health Inquiry
Productivity Commission
GPO Box 1428, Canberra City, ACT 2601

Contacts

Inquiry matters: Tracey Horsfall Ph: 02 6240 3261
Freecall number: Ph: 1800 020 083
Website: http://www.pc.gov.au/mental-health

Subscribe for inquiry updates

To receive emails updating you on the inquiry consultations and releases, subscribe to the inquiry at: http://www.pc.gov.au/inquiries/current/mentalhealth/subscribe

 

 Definition of key terms
Mental health is a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental illness or mental disorder is a health problem that significantly affects how a person feels, thinks, behaves and interacts with other people. It is diagnosed according to standardised criteria.

Mental health problem refers to some combination of diminished cognitive, emotional, behavioural and social abilities, but not to the extent of meeting the criteria for a mental illness/disorder.

Mental ill-health refers to diminished mental health from either a mental illness/disorder or a mental health problem.

Social and economic participation refers to a range of ways in which people contribute to and have the resources, opportunities and capability to learn, work, engage with and have a voice in the community. Social participation can include social engagement, participation in decision making, volunteering, and working with community organisations. Economic participation can include paid employment (including self-employment), training and education.

Productivity measures how much people produce from a given amount of effort and resources. The greater their productivity, the higher their incomes and living standards will tend to be.

Economic growth is an increase in the total value of goods and services produced in an economy. This can be achieved, for example, by raising workforce participation and/or productivity.

Sources: AIHW (2018b); DOHA (2013); Gordon et al. (2015); PC (2013, 2016, 2017c); SCRGSP (2018); WHO (2001).

An improvement in an individual’s mental health can provide flow-on benefits in terms of increased social and economic participation, engagement and connectedness, and productivity in employment (figure 1).

This can in turn enhance the wellbeing of the wider community, including through more rewarding relationships for family and friends; a lower burden on informal carers; a greater contribution to society through volunteering and working in community groups; increased output for the community from a more productive workforce; and an associated expansion in national income and living standards. These raise the capacity of the community to invest in interventions to improve mental health, thereby completing a positive reinforcing loop.

The inquiry’s terms of reference (provided at the front of this paper) were developed by the Australian Government in consultation with State and Territory Governments. The terms of reference ask the Commission to make recommendations to improve population mental health so as to realise higher social and economic participation and contribution benefits over the long term.

Assessing the consequences of mental ill-health

The costs of mental ill-health for both individuals and the wider community will be assessed, as well as how these costs could be reduced through changes to the way governments and others deliver programs and supports to facilitate good mental health.

The Commission will consider the types of costs summarised in figure 4. These will be assessed through a combination of qualitative and quantitative analysis, drawing on available data and cost estimates, and consultations with inquiry participants and topic experts. We welcome the views of inquiry participants on other costs that we should take into account.

 

NACCHO Aboriginal Youth and Mental Health : Download Report from @MissionAust and @blackdoginst

 ” It is critical that responses to support a young person’s mental health be culturally sensitive and gender sensitive and that they address the structural issues that contribute to higher levels of psychological distress for young females and for Aboriginal and Torres Strait Islander young people.

For example, we know that Aboriginal and Torres Strait Islander people continue to be adversely affected by racism, disconnection from culture, and the long history of dispossession. All of these factors contribute to poor mental health, substance misuse and higher suicide rates.

As a matter of priority, suicide prevention programs that are tailored to the needs of the whole community and focussed on prevention should be available to Aboriginal and Torres Strait Islander people. All programs should be offered in close proximity to community and should be age appropriate as well as culturally sensitive.”

Download a copy of the Five-Year Youth Mental Health Report

 youth-mental-health-report

NACCHO Background References (1-4)

Ref 1:  Read / research the 250 NACCHO Articles

about Aboriginal Mental Health published in past 5 years

about suicide prevention in the past 5 years

Ref 2 :Download the Draft Fifth National Mental Health Plan at the link below:

 “The release of the Draft Fifth National Mental Health Plan is another important opportunity to support reform, and it’s now up to the mental health sector including consumers and carers, to help develop a plan that will benefit all.”

A successful plan should help overcome the lack of coordination and the fragmentation between layers of government that have held back our efforts to date.”

NACCHO and Mental Health Australia CEO Frank Quinlan have welcomed the release of the Draft Fifth National Mental Health Plan and is encouraging all ACCHO stakeholders to engage with the plan during the upcoming consultation period.

Download the Draft Fifth National Mental Health Plan at the link below:

PDF Copy fifth-national-mental-health-plan

You can download a copy of the draft plan;or see extracts below

Fifth National Mental Health Plan – PDF 646 KB
Fifth National Mental Health Plan – Word 537 KB

Ref 3: NACCHO Chairperson, Matthew Cooke see previous press Release

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. 

Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. It is compounded by people’s lack of access to meaningful and ongoing education and employment. Drug and alcohol related conditions are also commonly identified in persons with poor mental health.

While there was no quick fix for the crisis, an integrated strategy led by Aboriginal community controlled health services is a good starting point.

The National Mental Health Commission Review recommended the establishment of mental health and social and emotional wellbeing teams in Aboriginal Community Controlled Health Services, linked to Aboriginal and Torres Strait Islander specialist mental health services.

None of these can be fixed overnight but we can’t ignore the problems. We are on the brink of losing another generation of Aboriginal people to suicide, poor health and substance abuse.”

What we do know is the solution must be driven by Aboriginal leaders and communities – a model that is reaping great rewards in the Aboriginal Community Controlled health sector.

It must be a community based approach, backed up by governments of all levels.”

NACCHO Chairperson, Matthew Cooke

Ref 4 : Extra info provided by Tom Calma

Prof Pat Dudgeon and Tom Calma chair the ATSI Mental Health and Suicide Prevention Advisory Group to the Commonwealth and Pat Chairs NATSIMHL, the group who created the Gayaa Dhuwi.

Bottom line is that the community should feel confident that all the major initiatives in mental health and suicide prevention are being lead by our people and more can be found at http://natsilmh.org.au

and http://www.psychology.org.au/reconciliation/whats_new/

and http://www.atsispep.sis.uwa.edu.au

Action urgently needed to stem rising youth mental illness

Last week Mission Australia released its joint Five-Year Youth Mental Health Report with Black Dog Institute, sharing the insights gathered about the mental health of Australia’s young people during the years 2012 to 2016.

Learning what young people think is so important to the work we do at Mission Australia. By checking in with them we discover their thoughts about their lives and their futures, and what concerns them most.

The Five Year Mental Health Youth Report presents the findings of the past five years on the rates of psychological distress experienced by young Australians, aged 15-19.

  • Almost one in four young people met the criteria for having a probable serious mental illness – a significant increase over the past five years (rising from 18.7% in 2012 to 22.8% in 2016).
  • Across the five years, females were twice as likely as males to meet the criteria for having a probable serious mental illness. The increase has been much more marked among females (from 22.5% in 2012 to 28.6% in 2016, compared to a rise from 12.7% to 14.1% for males).
  • Young people with a probable serious mental illness reported they would go to friends, parents and the internet as their top three sources of help. This is compared to friends, parents and relatives/family friends for those without a probable serious mental illness.
  • In 2016, over three in ten (31.6%) of Aboriginal and Torres Strait Islander respondents met the criteria for probable serious mental illness, compared to 22.2% for non-Indigenous youth.

In light of these findings, Catherine Yeomans, Mission Australia’s CEO said: “Adolescence comes with its own set of challenges for young people. But we are talking about an alarming number of young people facing serious mental illness; often in silence and without accessing the help they need.

The effects of mental illness at such a young age can be debilitating and incredibly harmful to an individual’s quality of life, academic achievement, and social participation both in the short term and long term.

Ms Yeomans said she was concerned that the mental health of the younger generation may continue to deteriorate without extra support and resources, including investment in more universal, evidence-based mental health programs in schools and greater community acceptance.

Given these concerning findings, I urge governments to consider how they can make a major investment in supporting youth mental health to reduce these alarming figures, Ms Yeomans said.

“We need to ensure young people have the resources they need to manage mental health difficulties, whether it is for themselves or for their peers. Parents, schools and community all play a vital role and we must fully equip them with the knowledge and skills to provide effective support to young people.”

The top issues of concern for those with a probable serious mental illness were: coping with stress; school and study problems; and depression. There was also a notably high level of concern about other issues including family conflict, suicide and bullying/emotional abuse.

The report’s finding that young people with mental illness are turning to the internet as a source of help with important issues also points to prevailing stigma, according to Black Dog Institute Director, Professor Helen Christensen.

“This report shows that young people who need help are seeking it reluctantly, with a fear of being judged continuing to inhibit help-seeking,” said Professor Christensen.

“Yet evidence-based prevention and early intervention programs are vital in reducing the risk of an adolescent developing a serious and debilitating mental illness in their lifetime. We need to take urgent action to turn this rising tide of mental illness.

“We know that young people are turning to the internet for answers and our research at Black Dog Institute clearly indicates that self-guided, online psychological therapy can be effective in reducing symptoms of depression and anxiety.

“While technology can be a lifeline, e-mental health interventions must be evidence-based and tailored to support young people’s individual needs. More investment is needed to drive a proactive and united approach to delivering new mental health programs which resonate with young people, and to better integrate these initiatives across schools and the health system to help young people on a path to a mentally healthier future.”

Armed with this information we are able to advocate on their behalf for the support services they need, and for the broader policy changes.

Download the NACCHO Mental Health Help APP to find your nearest ACCHO

 The Five-Year Youth Mental Health Report shows some alarming results with almost one in four young people meeting the criteria for a probable serious mental illness (PSMI). That figure has gone up from 18.7 per cent in 2012 to 22.8 per cent in 2016.

Girls were twice as likely as boys to meet the criteria for having a PSMI, and this figure rose from 22.5% in 2012 to 28.6% in 2016, compared to a rise from 12.7% to 14.1% for boys.

An even higher number of Aboriginal and Torres Strait Islander respondents met the criteria for having a probable serious mental illness (PSMI ) at 31%.

These results make it clear that mental illness is one of the most pressing issues in our communities, especially for young people, and one that has to be tackled by the governments, health services, schools and families.

Three quarters of all lifetime mental health disorders emerge by the age of 24, but access to mental health services for this age group is among the poorest, with the biggest barriers being community awareness, access and acceptability of services.

What we need is greater investment in mental health services that are tailored to the concerns and help seeking strategies of young people and are part of a holistic wrap around approach to their diverse needs.

For young women, we know that a large proportion (64%) were extremely or very concerned about body image compared to a far smaller number of males (34.8%).

Such a finding suggests that social pressures such as discrimination based on ideals of appearance may need to be addressed to tackle this gender disparity in the levels of probable serious mental illness among girls.

And although girls are more likely to be affected negatively by body image issues, they are more likely to seek help when they need it than boys.

Clearly then, and for a variety of reasons, an awareness of gendered differences is a crucial component in the management of mental health issues.

We need to ensure that all young people, whether they live in urban areas or regional, have the resources they need to manage mental health difficulties, whether it is for themselves or for their peers. Parents, schools and community all play a vital role and we must fully equip them with the evidence-based knowledge and skills to provide effective support to young people.

 

 

 

NACCHO #Aboriginal World Mental Health Day today October 10, why not make a #MentalHealthPromise at #WMHD16

mental-health

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. 

Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. It is compounded by people’s lack of access to meaningful and ongoing education and employment.

Drug and alcohol related conditions are also commonly identified in persons with poor mental health.”

NACCHO Chairperson, Matthew Cooke see previous NACCHO post

Read 120 NACCHO Mental health Articles

” Mental illness affects one in five Australians and today  World Mental Health Day – Monday 10 October – Mental Health Australia is encouraging all Australians to make a personal promise to improve their own mental health.

It doesn’t have to be New Year to make a resolution, and making a promise is an active step in improving mental health and wellbeing.

To get involved ahead of World Mental Health Day this year, and play an active role in your own mental health, make a #MentalHealthPromise at www.1010.org.au.

Promise to sleep well, promise to eat well, promise to plan, to tune in, or tune out. Promise to cut back, or switch off, promise to engage with others, promise to exercise, to talk or to seek help… Making a promise can be a positive first step towards improved mental health.

Mental Health Australia CEO Frank Quinlan, says the idea of making a promise reminds people that looking after their mental health is personal, and that it starts with them.

“The promise campaign has really captured people’s interest in recent years, and to see thousands of people post their promises on our 1010.org.au website and social media feeds, is a real step in helping improve one’s mental health,” said Mr Quinlan.

“The idea of making and sharing a promise also helps break down the stigma that still exists with mental illness. In the spirit of sharing, my mental health promise for World Mental Health Day is to keep finding quiet places amid the chaos.”

World Mental Health Day raises public awareness about mental health issues. The day promotes open discussion of mental disorders, and investments in prevention, promotion and treatment services.

If you or anyone you know needs help:

AOD

Contact your nearest Aboriginal Community Controlled  Health Service

Download the free NACCHO APP Or

NACCHO Aboriginal Health #SuicidePrevention : Kimberley doctor speaks about his battle against Indigenous suicide

doctor

 ” Recently, the federal government picked the Kimberley as one of its 12 suicide-prevention trial sites, a product of Prime Minister Malcolm Turnbull’s $192 million election pledge.

The health department’s media release talks mainly in the abstract about developing models of suicide prevention to “tailor specifically to the unique and often culturally sensitive requirements of remote and Indigenous communities”.

This will use, it adds, the “expertise and local knowledge to tailor mental health solutions specific to their community needs”.

Yes, this would be welcome. But to many, its sentiments and its promises are depressingly familiar.

They are impulsive acts while intoxicated. It can be after a small argument, a trivial argument with a relative, friend or partner, and they just go off and find some hose.”

There are no nice, comforting words to describe what confronts Associate Professor Murray Chapman.

See previous NACCHO Aboriginal Health post  : Duplication or what ? 40 Mental Health Services for one community , 95 in an other

and 85 NACCHO articles on Suicide Prevention

A psychiatrist, trained in the UK, he is currently clinical director of the Kimberley Mental Health and Drug Service (KMHDS), which puts him at the centre of a community whose heart and soul is being torn apart by suicide.

“When you look at Indigenous suicide, it’s a completely different pattern to non-Indigenous suicide. There are many cries for help [from the young] where you live. If someone isn’t going to get a pair of shoes, they will tell you they are going to be angry, they’ll tell you they are not going home, or something like that. Here, in the Kimberley, the response is the threat of suicide. It has become the lingua franca of despair.”

In July, Professor Chapman and colleagues published a report in the Medical Journal of Australia. It was based on an audit of the KMHDS internal suicide and self-harm database, based on referrals to the service, police reports, and reports from local hospitals and various non-government agencies.

It found that, in the 10 years from 2005-2014, there were 125 suicides in the Kimberley. Of these, 102 were by indigenous people, who were mostly male (71%), mostly young (68% under age 30) and were mostly by people who had never come into contact with the services run by Chapman. Virtually all were by hanging. This was in an estimated population of around 14,000, which equates to an age-adjusted suicide rate of 74 per 100,000 population, or seven times the national rate.

The media has long been stirred up by the topic. Earlier in the year, there were reports of a suspected suicide of a 10-year-old indigenous girl in WA. In response to the coverage, the WA State Coroner’s office announced it would hold an inquest, not just into what happened to the girl, but into another 20 recent suspected suicides.

But it is easy to find similar stories about child suicide in the news cuttings from the year before, and the year before that — similar stories stretching back over the past 15-20 years.

[Keane: are we succeeding in curbing suicide?]

The causes of the tragedy, which has unfolded across the Kimberley and much of remote northern Australia, are hugely complex, Chapman says. He talks about collective trauma, the effects of colonisation, the effects of decolonisation and the Stolen Generation.

He talks about the damage done by alcohol and communities now dealing with the fallout of fetal alcohol spectrum disorder, again at sky-high rates among those worse effected.

And then there is the basic poverty, the lives lived in the squats and slums.

“You are a young person and you have access to TV, you get Foxtel, and these kids can see the Kardashians and their ridiculous lifestyle and they look at what they have got. The mismatch of what is available and what to aspire to is substantial.”

As many indigenous leaders have pointed out over the years, Chapman says, suicide came late to indigenous Australia.

“From what we can gather in the Kimberley, until the ’60s or ’70s, and even the early ’80s, there was little in the way of suicide. But then it took off. It was at the time of the first royal commission into deaths in custody, and obviously it was partly about suicides happening in prison.

“When you look at the massive publicity in those days — there was a front cover of Time magazine with a picture of a noose — there was a recognised media effect [the Werther effect of copycat suicides] that helped push it into the community. It was probably already going that way, but [the publicity] really boosted it.”

Last month, the federal government picked the Kimberley as one of its 12 suicide-prevention trial sites, a product of Prime Minister Malcolm Turnbull’s $192 million election pledge.

The health department’s media release talks mainly in the abstract about developing models of suicide prevention to “tailor specifically to the unique and often culturally sensitive requirements of remote and Indigenous communities”.

This will use, it adds, the “expertise and local knowledge to tailor mental health solutions specific to their community needs”.

Yes, this would be welcome. But to many, its sentiments and its promises are depressingly familiar.

Back in 2007, for instance, WA State Coroner Alastair Hope began his inquest into the deaths of 22 indigenous people from suspected suicide. The idea was the same as now: to discover the broader reasons behind the individual tragedies.

Even with the distance of time, the findings make tough reading. Page after page recounting the final days or hours or moments of desperate people’s lives, short histories written in dry brutal bureaucratic words.

“During the preceding months the deceased had made several threats to harm himself … family and friends had, on occasions, physically removed objects from the deceased which could have been used as ligatures … at some point during the morning the deceased had a disagreement with his brother over a toy … a short time later he could not been seen … a search located him in front of a neighbouring house lying on the ground.”

[Trauma in the Kimberley: what life is like in remote indigenous communities]

The coroner’s report, which was published a year later, ran to more than 200 pages.

“In simple terms, it appears that Aboriginal welfare, particularly in the Kimberley, constitutes a disaster but no one is in charge of the disaster response,” Hope concluded.

He came up with 23 recommendations. He wrote about things as basic as changing the design in public housing so it was less about nuclear families and more about communal living.

He also wanted an end to a controversial work program for the indigenous unemployed, which he claimed, rather than offering meaningful work, seemed to result in what was called “sit down money” — money for doing nothing, which ended up fuelling alcohol misuse and the consequent havoc. But he also emphasised, first and foremost, the need to connect with Indigenous leadership.

Wes Morris, head of the Kimberley Aboriginal Law and Culture Centre, which originally called for the inquest, says, in the end, only three recommendations were taken up by governments — and they were simply the sort of recommendations governments are good at delivering, namely, the creation of more services.

‘Malignant grief’

The softer, less tangible demands, he says, were largely ignored.

“Did any of it work? No. If it had worked, we wouldn’t be going through another inquest 10 years later or needing a suicide prevention trial,” Morris said.

“They assiduously avoided the much harder recommendations, such as the recommendations about Indigenous leadership. The coroner found that there was no one steering the ship, no one driving the train. And that remains largely true today.”

Morris talks about funeral fatigue in the Kimberley, the days spent in mourning the dead, the cultural exhaustion and what was described by Dr Helen Milroy, Australia’s first indigenous doctor, as ‘malignant grief’ — the irresolvable, collective, cumulative grief that spreads through the body of indigenous culture, through the body of indigenous people with the form of human despair, which kills.

He quotes from the paper Cultural Wounds by Emeritus Professor Michael Chandler, a former professor of psychology at the University of British Columbia in Canada.

“If suicide prevention is our serious goal, then the evidence in hand recommends investing new moneys, not in the hiring of still more counsellors, but in organized efforts to preserve Indigenous languages, to promote the resurgence of ritual and cultural practices, and to facilitate communities in recouping some measure of community control over their own lives.”

A myth

Human rights campaigner Gerry Georgatos, who has been writing on indigenous suicide for more than a decade, is one of the many voices repeating their calls for a royal commission into a social horror story.

In March, as news of the suspected suicide of the 10-year-old girl broke, he wrote:

“I have travelled to hundreds of homeland communities and the people who are losing their loved ones are crying out to be heard, they are screaming.

“It is a myth and predominately a wider community perception that there is a silence, shame, taboo — it’s the listening that is not happening.”

As for Chapman, he remains clear about the limits of what can be done by statutory services while the bigger societal forces that have ravaged indigenous communities remain.

“We work together, but up here all our partners — the primary care teams, the police teams — are under resourced. It’s the inverse care law.

“I’m working on the edge of nowhere. I have the least resources and the most need. But we work together. Yes, we have a standard response [when someone dies] to stop clustering, to support families to minimise the risk of further suicide. We advocate and endure.”

Professor Chapman, who has spent the past 14 years in the Kimberley, adds: “We know we [mental health services] can’t stop it on our own. We have a certain role. We save one or two, but we are standing at the bottom of cliff.

“Trying to identify individuals at high risk and trying to react is like trying to capture lightning in a jar. But everyone thinks that is what we should be doing…It’s never going to work.”

*For support and information about suicide prevention, please call Lifeline on 13 11 14 or the Kids Helpline on 1800 55 1800.

*This article was originally published in Australian Doctor

NACCHO Aboriginal Health : Duplication or what ? 40 Mental Health Services for one community , 95 in an other

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“At one point there had been 95 different mental health services operating in the Pilbara town of Roebourne.

That had overwhelmed the community and prevented people from seeking support

We need our people who are already on the ground to be trained and supported to adequately deal with suicides in their communities,”

And we need more 24 hour services. Aboriginal people do not die by suicide between nine and five when services are open. They need to be able to access support around the clock.”

Michelle Nelson-Cox from the Aboriginal Health Council of WA

In one community there were more than 40 separate mental health services for a population of just 200 people, and most of their work was focused on three or four chronic mental health clients.”

 Dr Tracy Westerman 

 “There is a humanitarian crisis in this affluent nation, a catastrophic, systematic crisis: suicide accounts for more than 5% of Aboriginal and Torres Strait Islander deaths. It’s a staggering, harrowing statistic. 

The contributing factors are many and intertwined, underwritten by the kind of acute poverty, disadvantage and marginalisation that should make no sense in one of the world’s wealthiest nations.”

The suicide rate in Australia is a humanitarian crisis we can no longer ignore by

PHOTO : There is no greater legacy that any government can have than to prioritise and invest in the improving of lives, the changing of lives, the saving of lives.’ Photograph: Fairfax Media/Getty Images

Read 111 NACCHO Mental Health Articles here

Read 84 NACCHO Suicide Prevention Articles here

Duplication of mental health services in a number of Aboriginal communities is rendering many of them ineffective, according to organisations giving evidence to a Legislative Assembly committee in Perth the ABC reports

The Education and Health Standing Committee is examining Aboriginal youth suicides in Western Australia.

It has travelled around the state hearing submissions from a number of mental health service providers.

Dr Tracy Westerman runs a private company that provides psychological services to Aboriginal people.

She told the committee that in one community there were more than 40 separate mental health services for a population of just 200 people, and most of their work was focused on three or four chronic mental health clients.

“The community don’t know of the services and what they’re capable of providing to them,” Dr Westerman said.

“And the services are often not aware of each other. In reality the services are serving the same families again and again.”

She said better coordination and leadership was required.

“We need to go into really affected communities and look at where the needs are and where the gaps are and then develop models that we know have been effective in other communities,” Dr Westerman said.

Michelle Nelson-Cox from the Aboriginal Health Council of WA raised similar concerns.

She said at one point there had been 95 different mental health services operating in the Pilbara town of Roebourne.

That had overwhelmed the community and prevented people from seeking support, she said.

Ms Nelson-Cox told the committee the fly-in, fly-out nature of many services and the short contracts they were given often made them ineffective.

She said instead, communities needed to be consulted on what they needed.

“We need our people who are already on the ground to be trained and supported to adequately deal with suicides in their communities,” she said.

“And we need more 24 hour services. Aboriginal people do not die by suicide between nine and five when services are open. They need to be able to access support around the clock.”

The committee hearings wrap up today.

If you or anyone you know needs help:

The suicide rate in Australia is a humanitarian crisis we can no longer ignore

As I begin to write this piece, I have been informed of a former refugee who has taken his life, of a mother who has taken her life, of a young Aboriginal woman who has taken her life, of a former inmate who has taken his life, of a newly arrived migrant who has taken her life. Each of these individuals was aged in their 20s.

Suicide takes twice as many Australian lives as all other forms of violence combined, including homicides, military deaths and the road toll. The suicide toll should be the nation’s most pressing issue – the issue of our time. But alas it is not.

There is a humanitarian crisis in this affluent nation, a catastrophic, systematic crisis: suicide accounts for more than 5% of Aboriginal and Torres Strait Islander deaths. It’s a staggering, harrowing statistic. In fact in my estimations, because of under-reporting issues, suicide accounts for 10% of Indigenous deaths. The contributing factors are many and intertwined, underwritten by the kind of acute poverty, disadvantage and marginalisation that should make no sense in one of the world’s wealthiest nations.

But they are not limited to socioeconomic factors. From within the cesspool of this situational trauma – this narrative of victimhood – there has manifest a constancy of traumas – multiple, composite, aggressive, complex traumas.

We need more than just generalised counselling, but this last resort is the first resort. Resilience selling is part of this generalised counselling where we beg the victim to adjust their behaviours – but how far and for how long without hope on the horizon?

The factors that can culminate in suicide are the most preventable of the various destructive behaviours that impact on families and communities. There are many ways forward.

A national inquiry or royal commission into Aboriginal and Torres Strait Islander suicides – and in fact into all suicides – is long overdue. We cannot live in the silences and dangerously internalise this tragedy. I have travelled to hundreds of homeland communities and the people who are losing their loved ones are crying out to be heard, they are screaming.

Despite all the good work done by many in saving lives, the suicide toll, particularly for the most elevated risk groups, is on the increase. Without the deep examination that a royal commission will provide, the suicide prevention space will remain inauthentic – hostage to carpetbaggers and the ignorant.

Identifying trauma in any given population, including among LGBQTI people, former inmates, foster children, the homeless, the chronically impoverished, newly arrived migrants, culturally and linguistically diverse migrants and Aboriginal and Torres Strait Islanders, we start with behavioural observations and proceed with the opportunity for the individual to tell their story. People need people, 24/7.

Our capacity to listen is an imperative and must be achieved without judgment, for often redemption is needed: forgiveness in addition to sympathy and empathy. These skills do not come easy to everyone but they are vital in the suicide prevention space, in trauma counselling, in restorative therapies, in navigating people to a positive self.

There is no greater legacy that any government can have than to prioritise and invest in the improving of lives, the changing of lives, the saving of lives.

  • Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14 or Suicide Call Back Service 1300 659 467.

NACCHO Aboriginal Health : RACGP calls for urgent action to support the health and wellbeing of our youth

 risk-factors

It is totally unacceptable that Aboriginal and Torres Strait Islanders are experiencing the highest rate of youth suicide in the world among young Indigenous men aged 25-29.

“Improving the health of Aboriginal and Torres Strait Islander peoples is one of Australia’s highest health priorities and a whole-of-system reflection is urgently needed.”

Dr Frank R Jones, president of The Royal Australian College of General Practitioners PRESS RELEASE

Read all previous NACCHO Suicide prevention Articles ( Approx. 79 )

Youth Suicide Image Background Info

Aboriginal and Torres Strait Islander males are experiencing the highest rate of youth suicide in the world and health outcomes for all young Australians – particularly the disadvantaged – are falling. These disturbing results are revealed in a recent report Australian Youth Development Index 2016.

Commenting on the report, Dr Frank R Jones, president of The Royal Australian College of General Practitioners said that for GPs the report re-enforced the central concept that health risks not only affect a young person’s current state of health but also their health in years to come.

The other main health risk-related issues identified for youth between the ages of 15 and 29 years included alcohol, illicit drugs, sexually transmitted infections, obesity and mental illness.

“The report describes very worrying health trends among Australia’s youth and without urgent policy action to improve contextual social support systems and preventive healthcare services, it will get worse,” Dr Jones said.

The report, providing a snapshot of Australia’s 6.3 million young people aged between 10 and 29 years, reveals a significant decline in health and wellbeing since 2006, bucking the trend of other indicators which have seen positive increases such as educational attainment, employment opportunities and political engagement.

In addition to Indigenous disadvantage, marked disparities were found between urban and rural groups confirming inequities in health access and outcomes widening gaps for both groups.

“Whilst globally this report showed Australia had comparatively high youth development, it is clear there remains uneven results for our most disadvantaged young people confirming inequalities in social and health practices.

“We need to do more in terms of prevention and service responsiveness, particularly in areas of mental health care and drug abuse issues,” Dr Jones said.

“GPs play a crucial role in the provision of mental health services for all Australians but particularly so in rural and remote areas where there are less resources.”

RACGP Rural has been at the forefront in providing the necessary educational supports in the mental health arena, for our GP members who sometimes work in extremely challenging conditions.

Dr Jones said the RACGP is committed to raising awareness of the health needs for Aboriginal and Torres Strait Islander peoples and is a key signatory to the Close the Gap campaign.

The absence of an indicator around mental wellness limited the results in the report and needs capturing in future studies to help guide more supportive policy action in adolescent health interventions.

The RACGP believes in the equitable provision of health services and the discrepancy between health outcomes for youth in rural and urban areas, and youths of Indigenous and non-Indigenous communities is unacceptable.

Help

NACCHO #HealthElection16 : Parliamentary inquiry calls for royal commission into #Indigenous #suicide

IP-Feb16-fig1

“If we don’t have a royal commission into Aboriginal and Torres Strait Islander suicides, we are going have more suicides, the trends are going to keep on going up, we are going to keep on losing more lives.

We’re already losing more than five per cent of the Aboriginal and Torres Strait Islander population nationally to suicide. That’s abominable, that’s a humanitarian, a catastrophic humanitarian crisis.”

Suicide prevention worker, Gerry Georgatos, told politicians national action is needed via ABC PM

Photo above Centre for Suicide Prevention

“Mental Health Minister Andrea Mitchell today announced the first three of a total of seven suicide prevention co-ordinators scheduled for placement in Western Australia in 2016.

Co-ordinators will be placed in the Goldfields, Wheatbelt and South-West regions in the first phase of a $3.5 million initiative to promote suicide prevention, and increase community resilience and ability to respond to suicide”

WA Government Press Release see below

TONY EASTLEY: A West Australian parliamentary inquiry has been told a royal commission is needed to address the state’s Indigenous suicide rate.

The inquiry was launched after the death of a 10-year-old girl in a remote Kimberley community earlier this year.

Anthony Stewart has more.

ANTHONY STEWART: An estimated one in 19 Aboriginal people from WA will commit suicide.

State Parliament is examining the crisis, but today, suicide prevention worker, Gerry Georgatos, told politicians national action is needed.

GERRY GEORGATOS: If we don’t have a royal commission into Aboriginal and Torres Strait Islander suicides, we are going have more suicides, the trends are going to keep on going up, we are going to keep on losing more lives.

We’re already losing more than five per cent of the Aboriginal and Torres Strait Islander population nationally to suicide. That’s abominable, that’s a humanitarian, a catastrophic humanitarian crisis.

ANTHONY STEWART: WA was shocked into grappling with the issue after a 10-year-old girl committed suicide in March.

The child’s death in the remote Kimberley community of Looma, pushed the WA Parliament to establish an inquiry into youth suicides.

At today’s hearing, committee members repeatedly questioned those giving evidence about the merits of a royal commission.

Dr Graham Jacob chairs the inquiry.

GRAHAM JACOB: We have an open mind to that and we will continue to consider it and hopefully we will have our recommendations around November, before the end of the year.

ANTHONY STEWART: Late last year, the Federal Government established a critical incident team to help WA communities in the immediate aftermath of a suicide.

Evidence presented at the hearing has detailed how the team responded to three suicides in close succession just before Christmas in the Goldfields community of Leonora.

Adele Cox is part of the team which responded.

ADELE COX: Suicide in a lot of our communities, and particularly for young people, sadly has become quite normalised. You know, if something goes wrong, you know, that’s sort of one of the options that’s considered. We actually need to turn that around completely so that, you know, our kids never have suicide as a thought or an option.

ANTHONY STEWART: Ms Cox is also Bunuba and Gija woman from the Kimberley.

She called for more action within Aboriginal communities

ADELE COX: One suicide is one too many. You know, what does it take before we actually get some real change. Greater commitment from both governments, but also I think our own communities, you know. Ultimately as the keepers of our people, you know, we need to take some responsibility in terms of responding to our own mob’s needs as well.

ANTHONY STEWART: The Royal Commission into Aboriginal Deaths in Custody is now 25 years old.

Recommendations like the creation of the custody notification service continue to prevent Indigenous deaths in police watch-houses.

Gerry Georgatos says a similar level of national debate is needed to prevent suicides.

GERRY GEORGATOS: A royal commission, on the one hand, will help shift that national consciousness, will help educate the nation, but more importantly, will avail the nation, will avail the bureaucrats, will avail the policy-makers, will avail the parliamentarians, to what works in suicide prevention, and what type of political reform we need.

ANTHONY STEWART: To underline the urgency of this inquiry’s work, it was today informed there was another suicide in the Kimberley at the weekend.

This death happened in a community just visited by one of the politicians.

TONY EASTLEY: Anthony Stewart with that report.

And if you or anyone you know needs help you can call

Lifeline on 13 11 14,

FUNDING FOR SUICIDE PREVENTION CO-ORDINATORS

Wednesday, 22 June 2016

  • New suicide prevention co-ordinator roles for Goldfields, South-West and Wheatbelt
  • First phase of major $3.5 million initiative

Mental Health Minister Andrea Mitchell today announced the first three of a total of seven suicide prevention co-ordinators scheduled for placement in Western Australia in 2016.

Co-ordinators will be placed in the Goldfields, Wheatbelt and South-West regions in the first phase of a $3.5 million initiative to promote suicide prevention, and increase community resilience and ability to respond to suicide.

“These new positions fulfil a number of actions identified as part of the Liberal National Government’s Suicide Prevention 2020 Strategy,” Ms Mitchell said.

“These new co-ordinators will be facilitators to assist services on the ground to work in partnership to improve support and care for those affected by suicide and suicide attempts.

“While there is a range of support services available for people in crisis in regional areas, these new positions will increase the capacity of communities to identify and respond to suicide and related mental health issues as well as to promote suicide prevention services and initiatives.

“Co-ordinators will promote suicide prevention training and self-help activities to at-risk groups, as well as training for professionals and to first responders to a suicide.”

The Minister said phase two of the program, which would place co-ordinators in the Kimberley and Mid-West, would be announced soon, and the placement of two co-ordinators in the metropolitan area was also expected later in 2016.

The Mental Health Commission has signed agreements with Holyoake in the Wheatbelt, Hope Community Services in the Goldfields and St John of God Health Care in the South-West.

Fact File

  • The Liberal National Government’s $25.9 million suicide prevention strategy, Suicide Prevention 2020, includes six action areas, including providing local support and community prevention across the lifespan
  • On average, in WA one person loses their life to suicide each day

NACCHO #closethegap Suicide: Lifeline calls for specialist hotline to address high Indigenous suicide rates

 

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“There are some communities out there were there are a multitude of both state and federal services and showing very little for all the effort and the money,”

“The question is why? And I think part of the answer is that there needs to be much more involvement of Aboriginal people through governance structures that are appropriate to have a say how those resources are used.

“It’s important because many Aboriginal people will not be comfortable ringing a general service and speaking to a non-Aboriginal person.

“There needs to be, and I have seen this over my almost 40 years now in Aboriginal affairs, a specific service that is culturally appropriate.”

New South Wales parliamentarian and former state Labor leader Linda Burney said the Federal Government should seriously consider the proposal.

Ms Burney, who is a Wiradjuri woman and will be making a tilt at federal politics in the upcoming election, said a national, Aboriginal-led initiative was needed to address many of the issues surrounding mental health and disadvantage.

“Child suicide was a growing problem in indigenous communities. Children’s exposure to family violence was a “major contributor” to the mental health of young people.  services needed more funding for mental health, with remote communities having limited access through Aboriginal Medical Services and the Royal Flying Doctor Service. 

“We must be delivering services to the people, not (forcing) them to come to the services because Aboriginal people in remote communities are on the lowest incomes in the country.”

Sandy Davies, the deputy chairman of the National Aboriginal Community Controlled Health Organisation :Picture above : Indigenous children up to 14 years were nine times more likely to kill themselves than non-indigenous children

Crisis support service Lifeline is calling for the Commonwealth to support an Aboriginal-specific arm of the hotline, to tackle the high rates of suicide in Aboriginal communities.

Lifeline Central West, which covers about one third of New South Wales, has proposed establishing a national call centre in the central west city of Dubbo run by Aboriginal counsellors.

It has written a letter to the Federal Minister for Indigenous Affairs Nigel Scullion, asking for financial support for the so-called YarnUp Confidential service.

It was hoped the call centre would take up to 70,000 calls per year and create 118 new Aboriginal jobs in Dubbo, costing about $10 million to run annually.

Australian Bureau of Statistics figures released this week showed suicide rates among Indigenous people were about twice those of non-Indigenous people.

Lifeline Central West executive director Alex Ferguson said the rates would only continue to rise unless the Commonwealth took urgent action.

Mr Ferguson said while similar services were run locally in some communities, there was a need for a unified service based on the Lifeline model.

“Look at the scorecard and I think you’ll find their policies are either misdirected or failing,” Mr Ferguson said.

“At the moment we don’t have dialogue and we need to have a dialogue within the Aboriginal community and the broader regional communities.

“The idea is simply to put an Aboriginal feeling, a wash, a spirit through the Lifeline model, so that we can actually have Aboriginals working with Aboriginals under a properly trained and structured environment.”

‘They don’t trust us, in many cases they don’t like us’

Mr Ferguson said many Aboriginal people did not feel comfortable conveying their concerns to non-Indigenous counsellors.

“They don’t trust us, in many cases they don’t like us, and that’s why the YarnUp model is based on Aboriginals working with Aboriginals, but doing it in a very structured way, which is the Lifeline training and telephony model,” Mr Ferguson said.

Mr Ferguson said there had been an “uninspiring” response from the Government, and was disappointed it had not offered an alternative solution.

“Nobody has put up anything else to either push YarnUp our of the way and or has actually ever criticised the content of YarnUp,” Mr Ferguson said.

“By the time you keep going around this sort of ‘it’s not in my backyard’ type argument, there is the continual flow of death and the resultant trauma in the community.”

The Federal Member for Parkes Mark Coulton said the broadly supported the model and will next week lobby the Indigenous Affairs Minister Nigel Scullion for a trial.

But he said many local organisations were already doing similar work and there was a risk of duplicating services.

“I was in Bourke a couple weeks ago and there was another group there that has got a mental health program for school-aged students,” Mr Coulton said.

“This is not an empty field, there are a lot of people out there in this space.

“But I think the Lifeline model has worked well and I think to extend that into a specialised service for Aboriginal people will be I think a worthwhile exercise.”

Need for national, culturally appropriate approach

If you or anyone you know needs help, you can call Lifeline on 13 11 14.

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